Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $66.07 / $398.11	Facility		$12.30	$66.07	$398.11
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $97.72 / $165.96 / $218.78	Facility	25	$97.72	$165.96	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $24.55 / $70.79	Professional		$8.91	$24.55	$70.79
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $32.36 / $79.43	Professional	25	$18.20	$32.36	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $22.39 / $34.67	Professional		$8.51	$22.39	$34.67
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $22.91 / $29.51	Professional	25	$18.20	$22.91	$29.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $13.80 / $15.49	Facility		$11.22	$13.80	$15.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $24.55 / $39.81	Professional		$10.96	$24.55	$39.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Facility		$83.18	$83.18	$91.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $58.88	Professional		$22.91	$32.36	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $151.36 / $229.09	Facility		$28.18	$151.36	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $23.44 / $41.69	Professional		$9.77	$23.44	$41.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $12.02 / $38.90	Professional		$8.71	$12.02	$38.90
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
HealthNet Facility/Professional Professional Modifier 25 Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	25	$371.54	$371.54	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $20.89 / $42.66	Professional		$7.24	$20.89	$42.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $218.78 / $489.78	Professional		$22.91	$218.78	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $26.30 / $724.44	Professional		$13.18	$26.30	$724.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.20 / $74.13	Professional		$23.44	$30.20	$74.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $20.42 / $38.02	Facility		$8.13	$20.42	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $23.99 / $47.86	Professional		$10.00	$23.99	$47.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $75.86	Professional		$19.95	$23.99	$75.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $14.79 / $29.51	Professional		$7.94	$14.79	$29.51
United Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $22.91 / $48.98	Facility		$20.42	$22.91	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $17.38 / $35.48	Professional		$7.76	$17.38	$35.48